scholarly journals State of cerebral hemodynamics in patients with Chiari I malformation

2001 ◽  
Vol XXXIII (3-4) ◽  
pp. 18-23
Author(s):  
N. E. Krupina ◽  
L. I. Pyshkina ◽  
A. A. Kabanov

The special features of the cerebral hemodynamics were studied in 138 patients with Chiari I malformation (CM) with a help of magnetic resonance angiography (MRA) and transcranial dopplerography (TCD). MRA data analysis (58) revealed the frequent presence of vertebrobasilar system (VBS) maldevelopment and embryonic type of the circle of Willis. TCD data analysis (100) discovered vertebrobasilar insufficiency and bilateral blood flow increase in the intracranial part of the internal carotid arteries giving evidence of the compensated blood flow from the carotid system to the VBS. 21,0% of patients with CM and communicating hydrocephalia had TCD signs of intracranial hypertension. The most significant changes in cerebral hemodynamics were found in patients with marked pathology and elder than 30 years old.

Author(s):  
A.V. Shevtsov ◽  
S.L. Sashenkov ◽  
D.Z. Shibkova ◽  
P.A. Baiguzhin

Purpose: the article deals with providing a characteristic of muscle and tone status as well as precerebral and cerebral hemodynamics in kickboxers. Materials: 102 athletes with the qualification from the Second-class Athlete to the Master of Sport voluntary participated in the study. The average age of athletes at the moment of the study was 20.90±0.50. The average sports experience of participants was equal to 4.15±2.77. The control group consisted of apparently healthy young males of the same age but not involved in sports activities (n=35). The indicators of muscle tone and strength and cerebral blood flow were studied with the help of Doppler ultrasound of the main arteries of the head, electroneuromyography, and transcranial Doppler. Results: the article provides the results of the study on the effect of muscle and tone disturbances in the spinal motion segment on the functional status of precerebral and cerebral blood flow. The disturbances in nerve conduction velocity in the symmetrical groups of trunk muscles are considered as the reason for muscle imbalance in 50% of athletes. The analysis of blood flow indicators in kickboxers with muscle imbalance revealed a typical increase in the tone of precerebral vessels and changes in the gradients of blood flow velocity in various segments of the carotid and vertebral arteries. The decrease of cerebral blood flow in athletes, in particular, the venous outflow of a dystonic nature, is the result of spasmodic and ischemic Doppler patterns against a decreased indicator of arteriovenous balance. Mild traumatic brain injuries should also be taken into account when speaking about the development of cerebrovascular dysfunction as a result of kickboxers’ sparring activities and competitions. Conclusions: Differentiated disturbances in sensory and motor conductivity result in the disturbance of afferentation and muscle imbalance intensity. Angiospasm and vascular ischemia determine the increase in the linear blood flow velocity in the carotid system and the decrease in the vessels of the vertebrobasilar system against the increase in resistivity indicators in the carotid basins and vertebrobasilar system in kickboxers. Correlation analysis revealed visceral motor correlations, which proved the influence of the functional status of the regional muscle system on cerebral hemodynamics. The analysis of tone and strength muscle characteristics and cerebral blood flow in kickboxers indicates the necessity of correcting muscle and tone asymmetry of the paravertebral area.


Author(s):  
Yong Han ◽  
Min Chen ◽  
Hangzhou Wang

1998 ◽  
Vol 88 (2) ◽  
pp. 237-242 ◽  
Author(s):  
John L. D. Atkinson ◽  
Brian G. Weinshenker ◽  
Gary M. Miller ◽  
David G. Piepgras ◽  
Bahram Mokri

Object. Spontaneous spinal cerebrospinal fluid (CSF) leakage with development of the intracranial hypotension syndrome and acquired Chiari I malformation due to lumbar spinal CSF diversion procedures have both been well described. However, concomitant presentation of both syndromes has rarely been reported. The object of this paper is to present data in seven cases in which both syndromes were present. Three illustrative cases are reported in detail. Methods. The authors describe seven symptomatic cases of spontaneous spinal CSF leakage with chronic intracranial hypotension syndrome in which magnetic resonance (MR) images depicted dural enhancement, brain sagging, loss of CSF cisterns, and acquired Chiari I malformation. Conclusions. This subtype of intracranial hypotension syndrome probably results from chronic spinal drainage of CSF or high-flow CSF shunting and subsequent loss of brain buoyancy that results in brain settling and herniation of hindbrain structures through the foramen magnum. Of 35 cases of spontaneous spinal CSF leakage identified in the authors' practice over the last decade, MR imaging evidence of acquired Chiari I malformation has been shown in seven. Not to be confused with idiopathic Chiari I malformation, ideal therapy requires recognition of the syndrome and treatment directed to the site of the spinal CSF leak.


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